JP2004537389A - Interspinous prosthesis - Google Patents

Interspinous prosthesis

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Publication number
JP2004537389A
JP2004537389A JP2003520408A JP2003520408A JP2004537389A JP 2004537389 A JP2004537389 A JP 2004537389A JP 2003520408 A JP2003520408 A JP 2003520408A JP 2003520408 A JP2003520408 A JP 2003520408A JP 2004537389 A JP2004537389 A JP 2004537389A
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JP
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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JP2003520408A
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Japanese (ja)
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JP4947879B2 (en )
Inventor
パヴロフ、ポウル
マチュー、クラウド
レックマン、ベート
Original Assignee
ジンテーズ アクチエンゲゼルシャフト クールSynthes Aktiengesellschaft
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A61B17/7068Devices comprising separate rigid parts, assembled in situ, to bear on each side of spinous processes; Tools therefor

Abstract

棘突起間プロテーゼ(1)が棘突起間空間に導入可能な中間部分(2)を有し、この中間部分が中心軸線(4)と内端(7)と外端(8)とこの外端(8)から出発して中心軸線(4)に対して半径方向および直径方向に延びる延長部(3)とを有し、この延長部が2つの隣接する錐体の棘突起間空間に導入可能であり、プロテーゼ(1)に対して実質的に対称な相手部材(6)を受容するために中間部分(2)が、延長部(3)から離れた方のその内端(7)に軸線方向凹部(5)を有する。 The interspinous prosthesis (1) has a middle part (2) can be introduced into the interspinous space, the outer end and the outer end (8) the inner end the intermediate portion center axis line (4) (7) extension extending radially and diametrically relative to the central axis starting from (8) (4) (3) and has, this extension can introduce two interspinous space between adjacent cone , and the axis to the prosthesis its inner end towards the intermediate portion (2) for receiving a substantially symmetrical mating member (6), away from the extension (3) with respect to (1) (7) having a direction recesses (5).

Description

【技術分野】 【Technical field】
【0001】 [0001]
本発明は、請求項1の前文に係る棘突起間プロテーゼ、その相手部材、およびこれから組合せられた多部分構成の棘突起間プロテーゼに関する。 The present invention interspinous prosthesis according to the preamble of claim 1, the mating member, and a interspinous prosthesis now combined multi-part configuration.
【背景技術】 BACKGROUND OF THE INVENTION
【0002】 [0002]
このようなプロテーゼは、椎体の間の距離を本来なら狭めるであろうような椎間板欠損時に2つの隣接する椎体用のスペーサとして役立つ。 Such prosthesis, serve as two spacers for adjacent vertebral bodies distance when would you like disc defects in narrowing would otherwise between the vertebral bodies. 距離を再び拡大することによって椎間関節も負担軽減される。 Facet joint by increasing the distance again also burden.
【0003】 [0003]
WO99/42051により前文に係る棘突起間プロテーゼが公知であり、このプロテーゼは棘突起間空間に導入すべき中央部材を含み、‐移植実行後に‐2つの隣接する椎体の棘突起(processus spinosus)間空間内で中央部材を固定するために、この中央部材から頭方および尾方で各1対の耳片が中央部材の左右に延びている。 WO99 / ​​42051 by a known interspinous prosthesis according to the preamble, the prosthesis includes a central member to be introduced into the interspinous space, - the spinous process of vertebral body - two adjacent after transplantation execution (processus spinosus) to secure the central member between the space, the ear piece of the pair in the cephalad and Ogata extends to the left and right of the central member from the central member. この公知プロテーゼでは欠点としてその一体性が移植を困難とし、こうして棘上靭帯の除去が必要となる。 Its integrity as disadvantage with this known prosthesis is difficult to transplant, thus it is necessary to remove the supraspinous ligament. この靭帯の除去は、プロテーゼが背側では確たる支えを持たないという他の欠点をもたらす。 The removal of this ligament leads to another drawback of the prosthesis does not have a convincing support in the back side. この理由からWO99/42051では、プロテーゼの棘突起間中央部材に穿孔してそのなかに帯を挿通し、この帯でプロテーゼを隣接する椎体の棘突起に結び付けることができるようにすることが提案される。 In this reason WO99 / ​​42051, proposed to be drilled into the interspinous central member of the prosthesis is inserted a band within it, to the prosthesis in this band to be able to tie the spinous processes of the adjacent vertebral bodies It is. この仕方はきわめて時間がかかり複雑である。 This way is a complex takes very time.
【0004】 [0004]
先行技術の上記論議は本発明を取り巻く環境を説明するために行われるにすぎず、引用された先行技術がこの出願またはその優先権の時点に実際に刊行されまたは一般に周知でもあったことを意味するのではない。 Preceding the discussion of art is only carried out to describe the environment surrounding the present invention, it means that the cited prior art was also well known to actually published or general time of this application or its priority to the not be.
【0005】 [0005]
この点で本発明は救済策を提供せんとするものである。 The present invention in this respect is to St. provide remedies. 本発明の課題は、手術を全体として一層優しく行うことができかつ背側でのインプラントの保全が付加的手段なしに保証されているように、棘上靭帯を維持して移植することのできる棘突起間プロテーゼを提供することである。 Thorn object of the present invention, as surgery integrity of the implant in a more gentle performed it is possible and dorsal as a whole is guaranteed without additional means, that can be implanted to maintain the supraspinal ligament to provide a projection between prosthesis.
【0006】 [0006]
本発明はこの課題を多部分構成の棘突起間プロテーゼで解決し、その際個々の部分は異なる機械的性質を有することができる。 The present invention solves this problem by interspinous prosthesis of multi-part construction, the individual parts that case may have different mechanical properties.
【0007】 [0007]
本発明に係る棘突起間プロテーゼは実質的に棘突起間空間に導入可能な中間部分を含み、この中間部分は中心軸線と外端から出発して中心軸線に対して半径方向および直径方向に延びる2つの延長部とを有し、延長部は隣接する2つの椎体の棘突起間空間に導入可能である。 Interspinous prosthesis according to the present invention comprises a substantially introduced intermediate section in the interspinous space, extending radially and diametrically relative to the central axis intermediate portion, starting from the central axis and an outer end and two extensions, the extension can be introduced into the interspinous space of two adjacent vertebral bodies. さらに、中間部分には延長部から離れた方のその内端に軸線方向凹部が設けられており、この凹部はプロテーゼに対して実質的に対称な相手部材を受容するのに役立つ。 Further, the intermediate portion and the axial recess is provided on its inner end facing away from the extension, the recess serves to receive a substantially symmetrical counterpart member against the prosthesis.
【0008】 [0008]
好ましい実施形態において中間部分が連結手段を有し、この連結手段で相手部材がプロテーゼに固定可能である。 Has an intermediate portion connecting means in a preferred embodiment, the mating member in this connection means can be secured to the prosthesis. プロテーゼにおける延長部の位置と相手部材における延長部の位置が相手部材の固定時に互いに相対的に決定されているように連結手段は仕上げられている。 Position of the extension portion is coupled means is finished as is determined relative to one another during fixing of the mating member in the position and the mating member of the extension of the prosthesis. 好ましくは連結手段は止めを有する差込継手からなり、こうして相手部材をプロテーゼに固着するとプロテーゼおよび相手部材の延長部がその所要位置を占める。 Preferably coupling means comprises a bayonet joint having a stop, thus extension of the fixing the mating member to the prosthesis prosthesis and mating member occupies its required position. 差込継手の代りに両方の部分はねじ結合部または円錐体結合部によって互いに固定することができ、その場合プロテーゼと相手部材は好ましくは回転防止部を備えており、こうして相手部材は特定位置でのみプロテーゼの軸線方向凹部に導入可能である。 Both parts in place of the bayonet joint can be secured together by threaded connection or conical coupling portion, in which case the prosthesis and the counterpart member is preferably provided with an anti-rotation portion, thus in mating members specific position It can be introduced in the axial direction the recess of the prosthesis only. 他の構成の連結手段は少なくとも1つの弾性変形可能なカムであり、プロテーゼと相手部材との組立後にこのカムは相手部材に係止可能または係合可能である。 Coupling means having another configuration is at least one elastically deformable cam, the cam after the assembly of the prosthesis and the counterpart member can be lockable or engage the mating member.
【0009】 [0009]
本発明に係るプロテーゼの他の好ましい実施形態において連結手段は少なくとも1つの弾性変形可能なカムを含み、プロテーゼと相手部材との組立時にこのカムが弾性変形可能であり、またプロテーゼと相手部材との組立後は相補的凹部内に係合可能である。 Coupling means in the another preferred embodiment of a prosthesis according to the present invention comprises at least one elastically deformable cam, the cam during assembly of the prosthesis and the counterpart member is elastically deformed and the prosthesis and the counterpart member after assembly is engageable in a complementary recess.
【0010】 [0010]
好ましい1構成における、中心軸線に直角な横断面平面において: In a preferred configuration, the perpendicular cross-sectional plane to the central axis:
a)中間部分は最も狭い個所で内端領域の面積が50〜300mm 、好ましくは70〜250mm であり、 a) intermediate section area of the inner end region at the narrowest point 50 to 300 mm 2, preferably 70~250mm 2,
b)延長部の面積が70〜500mm 、好ましくは100〜450mm である。 b) the area of the extension is 70~500mm 2, preferably 100~450mm 2.
【0011】 [0011]
さらに、プロテーゼは好ましくは弾性材料から作製されており、こうして中間部分は半径方向で弾性変形可能である。 Furthermore, the prosthesis preferably is made of an elastic material, thus the intermediate portion is elastically deformable in the radial direction. 十分な半径方向弾性変形能はプロテーゼをプラスチックから製造することによって、または半径方向弾性変形可能な舌片を有する中間部分を形成することによって、達成可能である。 Sufficient radial elastic deformability by manufacturing prostheses of plastic or by forming an intermediate portion having a radial elastically deformable tongue, is achievable.
【0012】 [0012]
プロテーゼはエラストマー、シリコン、またはポリカーボネート系の高分子から作製することができる。 The prosthesis may be made elastomers, silicone or polycarbonate-based polymer. しかし、棘突起間空間内に置かれる中間部分の領域でプロテーゼの弾性が好適な機械的装置によって実現されるなら、金属材料からプロテーゼを仕上げることも可能である。 However, if the elasticity of the prosthesis in the region of the intermediate portion is placed in the interspinous space is achieved by a suitable mechanical device, it is possible to finish the prosthesis from a metal material.
【0013】 [0013]
本発明に係るプロテーゼの他の実施形態においてプロテーゼは中空に構成されており、その際中空壁はコラプシブルに構成しおよび/または空洞の充填によって膨張可能としておくことができる。 The prosthesis in another embodiment of a prosthesis according to the present invention is constructed hollow, where the hollow wall may have been inflatable by filling constitutes the collapsible and / or cavities. コラプシブルな中空壁は、弾性材料が可能とするよりも大きなプロテーゼ変形をこれによって可能とできる利点を有する。 Collapsible hollow wall has the advantage of a large prosthesis deformable possible by this than to enable the elastic material.
【0014】 [0014]
内端領域で中間部分はその外面を平滑または粗面に構成しておくことができる。 The intermediate portion at the inner end region may have been constituting the outer surface smooth or rough surfaces. 外面のこの構成によって骨の成長に影響を及ぼすことができ、粗い外面はプロテーゼに沿って骨の成長を促進する一方、平滑な外面はこの成長を困難にしまたは妨げることさえある。 Can influence the growth of the bone by the structure of the outer surface, a coarse outer surface while promoting the growth of bone along the prosthesis, smooth outer surface may even interfere with or complicate this growth. 骨に接触したインプラントの表面はヒドロキシアパタイト(HA)を埋め込むことによって保護することもできる。 Surface of the implant in contact with the bone can be protected by embedding a hydroxyapatite (HA).
【0015】 [0015]
好ましい実施形態において本発明に係る相手部材は内端と外端とこの外端から出発したやはり半径方向および直径方向に延びる2つの延長部とを含み、延長部は隣接する2つの椎骨の棘突起の間のプロテーゼに対向する空間内に挿入可能である。 Preferred mating member according to the present invention in embodiments comprises an inner and outer ends and two extensions extending also radially and diametrically starting from the outer edge, the extension barbs two vertebrae adjacent projections it is insertable into the space opposed to the prosthesis between. さらに、相手部材にピンが内端に向けて取付けられており、このピンがプロテーゼの凹部に導入可能である。 Further, mounted toward the pin inner end to the mating member, the pin can be introduced into the recess of the prosthesis. こうして移植時にプロテーゼと相手部材との厳密な整列を達成することができる。 Thus it is possible to achieve exact alignment of the prosthesis and the counterpart member at the time of implantation.
【0016】 [0016]
プロテーゼと同様に相手部材は類似もしくは相補的連結手段を装備しておくことができる。 Mating member like the prosthesis may have been equipped with a similar or complementary coupling means. やはりこれらの連結手段は差込継手、弾性変形可能なカム、ねじ結合部または円錐体結合部を含むことができる。 Again these coupling means can comprise bayonet joint, elastically deformable cam, a screw connection or a cone connection. 同様に相手部材に類似もしくは相補的回転防止部を取付けておくことができる。 Similarly it is possible to have attached a similar or complementary anti-rotation portion in the mating member.
【0017】 [0017]
相手部材を有する本発明に係る棘突起間プロテーゼの好ましい実施形態は、組立状態のときプロテーゼが中心軸線に直角な対称平面を有し、棘突起間プロテーゼの延長部が相手部材の延長部に対して中心軸線と平行に見て少なくとも2mm、好ましくは少なくとも3mmの距離を有する。 A preferred embodiment of the interspinous prosthesis according to the present invention having a mating member, the prosthesis when assembled state has a perpendicular plane of symmetry to the central axis, the extension of the interspinous prosthesis relative extension of the mating member at least 2mm as viewed in parallel with the central axis Te, preferably have a distance of at least 3 mm. 棘突起間プロテーゼの延長部と相手部材の延長部との最大距離は15mm、好ましくは12mmである。 The maximum distance between the extension of the extended portion and the mating member of the interspinous prosthesis 15 mm, preferably 12 mm.
以下、複数の実施例の一部略示した図面を基に本発明と本発明の諸構成をなお詳しく説明する。 Hereinafter, still it is described in detail various configurations of the present invention and the present invention based on the drawings in which a part shown schematically in several embodiments.
【0018】 [0018]
図1に棘突起間プロテーゼ1が相手部材6と組立状態で示してある。 Interspinous prosthesis 1 is shown in mating members 6 and the assembled state in FIG. プロテーゼ1の中間部分2はプロテーゼ1の内端7が相手部材6に隣接している。 Middle part 2 of the prosthesis 1 is the inner end 7 of the prosthesis 1 is adjacent the mating member 6. プロテーゼ1の外端8に両方の延長部3が中心軸線4に垂直に、互いに直径上で向き合わせて配置されている。 Both extensions 3 of the outer end 8 of the prosthesis 1 is perpendicular to the central axis 4, are disposed opposed diametrically to each other. 延長部3はここに示す実施形態では楕円体の半片として実施されている。 Extension 3 is in the embodiment shown here is embodied as halves of an ellipsoid. 相手部材6のやはり半径方向および互いに直径方向で向き合う延長部3は中心軸線4に直角な平面に対して対称に配置されている。 Extensions also facing in the radial direction and the diameter directions of the mating member 6 3 are arranged symmetrically with respect to a plane perpendicular to the central axis 4. 中心軸線4と平行に見たプロテーゼ1の横断面において対称に配置される半径方向カム17がプロテーゼ1と相手部材6との間の回転防止部として役立ち、このカムは中間部分2でプロテーゼ1の内端7から突出し、相手部材6の相補的溝18内に係合する。 It serves as a rotation prevention portion between the radial cam 17 which is arranged symmetrically in the central axis 4 and the cross section of the parallel saw prosthesis 1 and prosthesis 1 and the counterpart member 6, the cam of the prosthesis 1 in the middle part 2 It protrudes from the inner end 7, engages in a complementary groove 18 of the mating member 6. 中心軸線4と同軸で中間部分2が凹部5を含み、この凹部は内端7の方からプロテーゼ1内に深さTまで達している。 Comprises an intermediate portion 2 a recess 5 at the central axis 4 coaxial, the recess has reached from the direction of the inner end 7 to a depth T in the prosthesis 1. 相手部材6が栓16を有し、この栓は凹部5に対して相補的に構成されており、従ってプロテーゼ1と相手部材6を組立てると凹部5内に導入可能である。 Mating member 6 has a plug 16, the plug can be introduced into complementarily is composed, hence the prosthesis 1 and assemble the mating member 6 when the concave portion 5 with respect to the recess 5.
【0019】 [0019]
さらにプロテーゼ1は、プロテーゼ1の外端8に当接可能なボルト頭部26を有する固定ボルト19を含む。 Further prosthesis 1 comprises a fixing bolt 19 having a contact capable bolt head 26 to the outer end 8 of the prosthesis 1. 固定ボルト19は中心軸線4と同軸でプロテーゼ1に挿通可能であり、相手部材6の栓16内で差込継手27によって係止可能であり、こうしてプロテーゼ1は相手部材6と脱離可能に鎖錠可能である。 Fixing bolt 19 is insertable into the prosthesis 1 with the central axis 4 coaxial, and be locked by the bayonet joint 27 in the plug 16 of the mating member 6, thus the prosthesis 1 is mating member 6 and detachably chain it is possible to lock. 固定ボルト19と相手部材6は中心軸線4と同軸な穴20が連続的に穿孔され、こうしてプロテーゼ1と相手部材6は半径方向でコラプシブルである。 Fixing bolts 19 and the mating member 6 is the central axis 4 coaxial with the hole 20 is continuously perforated, thus the prosthesis 1 and the counterpart member 6 is collapsible radially.
【0020】 [0020]
図2は相手部材6を有するプロテーゼ1の他の実施形態を組立状態で示す。 Figure 2 shows another embodiment of a prosthesis 1 having a mating member 6 in the assembled state. 凹部5はプロテーゼ1を同軸で内端7から外端8まで貫通している。 Recess 5 penetrates from the inner end 7 to the outer end 8 of the prosthesis 1 coaxially. 相手部材6の栓16はプロテーゼ1と相手部材6を組立てると連続した凹部内に、プロテーゼ1の内端7が相手部材6の延長部3に当接するまで押し込まれる。 Plug 16 of the mating member 6 is in a contiguous in the recess and assembled prosthesis 1 and the counterpart member 6, the inner end 7 of the prosthesis 1 is pushed until it abuts against the extension 3 of the mating members 6. さらに、相手部材6は外端15と内端14との間を穴20と連続的に穿孔されている。 Furthermore, mating member 6 is continuously perforated with holes 20 between the inner end 14 and outer end 15. 連結手段11はねじ結合部として構成されており、ねじ21はプロテーゼ1の凹部5と相手部材6の穴20とに通してプロテーゼ1の外端8から相手部材6の外端15に至るまで挿通され、ナット22で鎖錠可能である。 Connection means 11 is designed as a screw connection, through the screw 21 from the outer end 8 of the prosthesis 1 through the hole 20 of the recess 5 and the mating member 6 of the prosthesis 1 up to the outer end 15 of the mating member 6 it is a possible locking nut 22. さらに、プロテーゼ1が空洞12付きで構成されており、こうして空洞壁13は選択的にコラプシブル、または空洞12に充填材を充填することによって膨張可能である。 Moreover, the prosthesis 1 is configured with a cavity 12, the cavity wall 13 thus is expandable by filling a filler selectively collapsible or cavity 12,.
【0021】 [0021]
図3に示す実施形態が上記実施形態と相違する点として、相手部材6の栓16がプロテーゼ1の凹部5に完全に挿通され、こうして相手部材6の内端14がプロテーゼ1の外端8と一直線に並ぶ。 As the point at which the embodiment shown in FIG. 3 differs from the above-described embodiment, the plug 16 of the mating member 6 is fully inserted in the recess 5 of the prosthesis 1, thus the inner end 14 of the mating member 6 and the outer end 8 of the prosthesis 1 line up in a straight line. さらに、相手部材6は内端14から外端15に至るまで連続した複数の穴20を有し、それらの穴軸線は中心軸線4と平行に延びている。 Furthermore, mating member 6 has a plurality of holes 20 that are continuous from the inner end 14 up to the outer end 15, the holes axes extend parallel to the center axis 4. これらの穴20にセルクラージュ針金23を通すことができ、セルクラージュ針金は棘突起間プロテーゼ1および相手部材6を固定するのに役立つ。 Can in these holes 20 through the cerclage wire 23, cerclage wire serves to fix the interspinous prosthesis 1 and the mating member 6.
【0022】 [0022]
図4に示す実施形態は、連結手段11が係止ボルト28を含み、この係止ボルトが中心軸線4と同軸でプロテーゼ1および相手部材6を貫通した穴20に挿通可能であることによって、図1に示す実施形態と相違しているにすぎない。 The embodiment shown in Figure 4, by connecting means 11 includes a locking bolt 28, the locking bolt can be inserted into a hole 20 extending through the prosthesis 1 and the counterpart member 6 with the central axis 4 coaxial, FIG only it differs from the embodiment shown in 1. 係止ボルト28はその頭部29が相手部材6の外端15に当接可能であり、またその先端には半径方向変形可能なカム31を有する。 Locking bolt 28 the head 29 is capable of abutting the outer end 15 of the mating member 6, also at its distal end with a radially deformable cam 31. このカムはプロテーゼ1と相手部材6とを組立てると穴20の直径よりも大きな直径の旋削部30内に係合することができ、こうしてプロテーゼ1と相手部材6はしっかり保持される。 The cam can be engaged to the prosthesis 1 and the counterpart member 6 and the assembled when turned portion 30 of larger diameter than the diameter of the hole 20, thus the prosthesis 1 and the counterpart member 6 is firmly held. 係止ボルト28を穴20に導入するためにカム31は軸線方向に配置される溝孔32によって中心軸線4に垂直に圧縮することができ、こうして係止ボルト28が穴20に挿通可能である一方、組立状態のときカム31は弾力的にばね力で戻り、プロテーゼ1の旋削部30内に係合する。 Cam 31 in order to introduce the locking bolt 28 into the hole 20 may be compressed perpendicularly to the central axis 4 by slot 32 arranged in the axial direction, thus locking the bolt 28 can be inserted into the hole 20 on the other hand, the cam 31 when the assembled state resiliently return by the spring force, it engages in the turning portion 30 of the prosthesis 1. 係止ボルト28は中心軸線4と同軸で連続的に穿孔されており、こうしてピン25が挿通可能であり、これによりカム31の半径方向ばね伸縮が妨げられる。 Locking bolt 28 is continuously perforated with a central axis 4 coaxial, thus the pin 25 is insertable, thereby radially spring stretching of the cam 31 is prevented.
【0023】 [0023]
図5には相手部材6を有する本発明に係るプロテーゼ1の他の実施形態が示してある。 In Figure 5 there is shown another embodiment of a prosthesis 1 according to the present invention having a mating member 6. プロテーゼ1の外端8と相手部材6の外端15とに延長部3が中心軸線4に垂直にかつ互いに直径上で向き合わせて取付けられており、この実施形態において延長部3は中心軸線4と平行に半円形横断面を有する。 Extension on the outer end 15 of the outer end 8 and the mating member 6 of the prosthesis 1 3 is mounted in opposed on vertically and diameter to one another to the central axis 4, the extension 3 in this embodiment the central axis 4 parallel with a semi-circular cross-section and. 凹部5はプロテーゼ1を内端7から外端8に至るまで中心軸線4と同軸で貫通している。 Recess 5 penetrates the center axis 4 is coaxial with the prosthesis 1 from the inner end 7 up to the outer end 8. 極く大きなねじピッチを有する雌ねじ36が凹部5内に取付けられている。 Internal thread 36 having a very large thread pitch is mounted in the recess 5. 相手部材6はやはり内端14に隣接して栓16を有し、この栓が雌ねじ36に相補的な雄ねじ33を有し、こうしてプロテーゼ1と相手部材6はこのねじ結合部によって互いに脱離可能に固着可能である。 Mating member 6 has a stopper 16 adjacent to the inner edge 14 again has a complementary male thread 33 the plug into the female screw 36, thus the prosthesis 1 and the counterpart member 6 can desorption each other by the threaded connection It can be secured to. 栓16と延長部3との間で相手部材6に第1鋸歯状歯34が取付けられており、この歯はプロテーゼ1を相手部材6と組立てるとプロテーゼ1の内端7の相補的第2歯35とかみ合うことができ、こうして歯34;35の非対称構成によってプロテーゼ1および相手部材6の意図しない脱離に備えた安全が講じられる。 And first serrated teeth 34 is attached to the mating member 6 between the plug 16 and the extension portion 3, the complementary second tooth of the inner end 7 of the tooth prosthesis 1 when assembled prosthesis 1 with the mating member 6 It can mesh with 35, thus the tooth 34; safety are taken with the unintended detachment of the prosthesis 1 and the counterpart member 6 by an asymmetric arrangement of 35.
【図面の簡単な説明】 BRIEF DESCRIPTION OF THE DRAWINGS
【0024】 [0024]
【図1a】相手部材を有する本発明に係る棘突起間プロテーゼの好ましい実施形態の断面図である。 Figure 1a is a cross-sectional view of a preferred embodiment of the interspinous prosthesis according to the present invention having a mating member.
【図1b】相手部材を有する本発明に係るプロテーゼの図1aに示す実施形態の側面図である。 Figure 1b is a side view of the embodiment shown in Figure 1a of the prosthesis according to the present invention having a mating member.
【図2】相手部材を有する本発明に係る棘突起間プロテーゼの他の実施形態の断面図である。 2 is a cross-sectional view of another embodiment of the interspinous prosthesis according to the present invention having a mating member.
【図3】相手部材を有する本発明に係る棘突起間プロテーゼの他の実施形態のやはり断面図である。 3 is a still sectional view of another embodiment of the interspinous prosthesis according to the present invention having a mating member.
【図4】相手部材を有する本発明に係る棘突起間プロテーゼの他の実施形態の断面図である。 4 is a cross-sectional view of another embodiment of the interspinous prosthesis according to the present invention having a mating member.
【図5】相手部材を有する本発明に係る棘突起間プロテーゼの他の実施形態の図である。 5 is a diagram of another embodiment of the interspinous prosthesis according to the present invention having a mating member.
【符号の説明】 DESCRIPTION OF SYMBOLS
【0025】 [0025]
1 プロテーゼ 2 中間部分 3 延長部4 中心軸線 5 軸線方向凹部 6 相手部材7、14 内端 8、15 外端 11 連結手段12 空洞 13 空洞壁 20 穴27 差込継手 31 カム 1 prosthesis 2 intermediate part 3 extension 4 central axis 5 the axial recess 6 mating member 7,14 inner end 8,15 outer end 11 the connection means 12 a cavity 13 cavity wall 20 holes 27 bayonet joint 31 cam

Claims (32)

  1. 棘突起間プロテーゼであって、棘突起間空間に導入可能な中間部分(2)を有し、この中間部分が中心軸線(4)と内端(7)と外端(8)とこの外端(8)から出発して中心軸線(4)に対して半径方向および直径方向に延びる2つの延長部(3)とを有し、この延長部が隣接する2つの椎体の棘突起間空間内に導入可能であり、中間部分(2)が、延長部(3)から離反した方のその内端(7)に、プロテーゼ(1)に対して実質的に対称な相手部材(6)を受容するための軸線方向凹部(5)を有するものにおいて、 A interspinous prosthesis having an intermediate portion (2) which can be introduced into the interspinous space, the outer end and inner end intermediate portion center axis line (4) (7) the outer end (8) (8) and two extensions extending in the radial direction and the diameter direction (3) to the central axis starting (4) from the interspinous space of two vertebral bodies this extension is adjacent can be introduced into the acceptor middle part (2) comprises at its inner end facing away from the extension (3) (7), substantially symmetrical mating member (6) relative to the prosthesis (1) in those with an axial recess (5) for,
    プロテーゼが弾性材料からなり、この材料が中間部分(2)の最も狭い個所(10)で未負荷直径に対して相対的に直径の10〜60%弾性変形を可能とすることを特徴とするプロテーゼ(1)。 Prosthesis prosthesis is made of an elastic material, characterized in that the material to allow 10% to 60% elastic deformation of the relatively diameter relative to the unloaded diameter at the narrowest point of the middle part (2) (10) (1).
  2. 中間部分(2)が連結手段(11)を有し、この連結手段で相手部材(6)が中間部分に固定可能であることを特徴とする、請求項1記載のプロテーゼ(1)。 An intermediate portion (2) is coupling means (11), wherein the mating member in this connection means (6) can be fixed to an intermediate portion of claim 1, wherein the prosthesis (1).
  3. 中心軸線(4)に直角な横断面平面(9)において中間部分(2)が内端(7)領域の最も狭い個所(10)に50〜300mm 、好ましくは70〜250mm の面積を有することを特徴とする、請求項1または2記載のプロテーゼ(1)。 The central axis (4) to 50 to 300 mm 2 in the intermediate portion (2) is an inner end (7) the narrowest point of the region (10) in a perpendicular cross-sectional plane (9), preferably has an area of 70~250Mm 2 characterized in that, according to claim 1 or 2, wherein the prosthesis (1).
  4. 中心軸線(4)に直角な横断面平面において延長部(3)が70〜500mm 、好ましくは100〜450mm の面積を有することを特徴とする、請求項1〜3のいずれか1項記載のプロテーゼ(1)。 Extensions in perpendicular cross-sectional plane the central axis (4) (3) is 70~500mm 2, preferably characterized in that it has an area of 100~450mm 2, any one of claims 1 to 3 of the prosthesis (1).
  5. 弾性材料が未負荷直径に対して相対的に15〜50%の弾性変形を可能とすることを特徴とする、請求項1〜4のいずれか1項記載のプロテーゼ(1)。 Wherein the elastic material to allow relative 15% to 50% of the elastic deformation with respect to the unloaded diameter, any one of claims prosthesis of claims 1 to 4 (1).
  6. プロテーゼがショア硬さ65A〜90Aのプラスチックからなることを特徴とする、請求項1〜5のいずれか1項記載のプロテーゼ(1)。 Prosthesis characterized in that it consists of a plastic having a Shore hardness 65A~90A, any one of claims prosthesis of claims 1 to 5 (1).
  7. プロテーゼが金属材料からなり、中間部分(2)が半径方向弾性変形可能な舌片を含むことを特徴とする、請求項1〜5のいずれか1項記載のプロテーゼ(1)。 Prosthesis made of a metal material, an intermediate portion (2) is characterized in that it comprises a radial elastically deformable tongue, set forth in any one prosthesis of claims 1 to 5 (1).
  8. プロテーゼが中空に構成されており、その空洞壁(13)が選択的にコラプシブル、または空洞(12)に充填材を充填することによって膨張可能であることを特徴とする、請求項1〜7のいずれか1項記載のプロテーゼ(1)。 Prosthesis is configured hollow, characterized in that it is expandable by the cavity wall (13) is filled with a filler selectively collapsible or cavity (12), of claim 1 to 7 any one of claims prosthesis (1).
  9. 中間部分(2)がその内端(7)の領域でその外面は平滑に構成されていることを特徴とする、請求項1〜8のいずれか1項記載のプロテーゼ(1)。 Wherein the intermediate portion (2) whose outer surface is configured to smooth in the region of its inner end (7), any one of claims prosthesis of claims 1 to 8 (1).
  10. 中間部分(2)がその内端(7)の領域でその外面は粗面化されていることを特徴とする、請求項1〜8のいずれか1項記載のプロテーゼ(1)。 Wherein the intermediate portion (2) whose outer surface which is roughened in the region of its inner end (7), any one of claims prosthesis of claims 1 to 8 (1).
  11. その表面の少なくとも一部でヒドロキシアパタイト(HA)がプロテーゼ材料に埋め込まれていることを特徴とする、請求項1〜10のいずれか1項記載のプロテーゼ(1)。 At least a portion hydroxyapatite (HA) is equal to or embedded in the prosthesis material, any one of claims prosthesis of claims 1 to 10 for the surface (1).
  12. 連結手段(11)が差込継手(27)を含むことを特徴とする、請求項2〜11のいずれか1項記載のプロテーゼ(1)。 Coupling means (11) is characterized in that it comprises a bayonet joint (27), any one of claims prosthesis of claim 2 to 11 (1).
  13. 連結手段(11)が弾性変形可能なカム(31)を含み、プロテーゼ(1)と相手部材(6)との組立後にこのカムが相手部材に係止可能であることを特徴とする、請求項2〜11のいずれか1項記載のプロテーゼ(1)。 Coupling means (11) comprises an elastically deformable cams (31), characterized in that the cam after assembly of the prosthesis (1) and mating member (6) can be locked to the mating member, claim set forth in any one prosthesis 2 to 11 (1).
  14. 少なくとも連結手段(11)が中心軸線(4)と同軸で穴(20)を備えており、プロテーゼ(1)がこの穴(20)に導入可能なピンを含むことを特徴とする、請求項13記載のプロテーゼ(1)。 At least coupling means (11) is the center axis line (4) provided with a hole (20) coaxially, the prosthesis (1) is characterized in that it comprises a introducible pin into the hole (20), according to claim 13 prosthesis of claim (1).
  15. 連結手段(11)が円錐体結合部を含むことを特徴とする、請求項2〜11のいずれか1項記載のプロテーゼ(1)。 Coupling means (11) is characterized in that it comprises a cone coupling portion, any one of claims prosthesis of claim 2 to 11 (1).
  16. 連結手段(11)がねじ結合部を含むことを特徴とする、請求項2〜11のいずれか1項記載のプロテーゼ(1)。 Characterized in that it comprises a coupling means (11) screwed portion, any one of claims prosthesis of claim 2 to 11 (1).
  17. プロテーゼ(1)が相手部材(6)内に受容可能な回転防止部を含むことを特徴とする、請求項13〜16のいずれか1項記載のプロテーゼ(1)。 The prosthesis (1) is characterized in that it comprises a rotation preventing portion capable received within mating member (6), any one of claims prosthesis of claim 13 to 16 (1).
  18. 中間部分(2)の軸線方向凹部(5)が中間部分全体を貫通する連続した穴として構成されていることを特徴とする、請求項1記載のプロテーゼ(1)。 Wherein the axial recess in the middle part (2) (5) is configured as a continuous bore through the entire middle portion of claim 1, wherein the prosthesis (1).
  19. 中心軸線(4)と平行に見て延長部(3)の横断面が半円面であることを特徴とする、請求項1〜18のいずれか1項記載のプロテーゼ(1)。 The central axis (4) and the extension portion when viewed in parallel cross section of (3) is characterized in that it is a semi-circular surface, any one of claims prosthesis of claims 1 to 18 (1).
  20. 請求項1〜19のいずれか1項記載のプロテーゼ(1)用の相手部材において、 In mating member of prosthesis (1) according to any one of claims 1 to 19,
    A)相手部材(6)が内端(14)と外端(15)と; A) mating member (6) is an inner end (14) and an outer end (15);
    B)この外端(15)から出発して中心軸線(4)に対して半径方向および直径方向に延びる2つの延長部(3)とを含み、延長部が隣接する2つの椎骨の棘突起間空間に導入可能であり、さらに相手部材がc)内端(14)に向けて栓(16)を含み、この栓がプロテーゼ(1)の凹部(5)に導入可能であることを特徴とする相手部材。 B) between the outer edge (15) starting from the central axis (4) two extensions extending in the radial direction and the diameter direction relative to and a (3), the spinous process of two vertebrae extension is adjacent can be introduced into the space, further comprising a stopper (16) toward the mating member c) the end (14), characterized in that the plug can be introduced into the recess (5) of the prosthesis (1) the other party member.
  21. 栓(16)が連結手段(11)を含み、この連結手段でプロテーゼ(1)が相手部材に固定可能であることを特徴とする、請求項20記載の相手部材(6)。 Includes a plug (16) coupling means (11), the prosthesis in the connecting means (1) is characterized in that it is fixed to the mating member, according to claim 20, wherein the mating member (6).
  22. 連結手段(11)が差込継手を含むことを特徴とする、請求項21記載の相手部材(6)。 Coupling means (11) is characterized in that it comprises a bayonet joint, according to claim 21, wherein the mating member (6).
  23. 連結手段(11)が弾性変形可能なカムを含み、相手部材(6)とプロテーゼ(1)との組立後にこれらのカムが相手部材に係止可能であることを特徴とする、請求項21記載の相手部材(6)。 Coupling means (11) comprises an elastically deformable cam, after assembly of the mating member (6) and the prosthesis (1) of these cams, characterized in that lockable to the other member, according to claim 21, wherein of the mating member (6).
  24. 連結手段(11)が円錐体結合部を含むことを特徴とする、請求項21記載の相手部材(6)。 Coupling means (11) is characterized in that it comprises a cone coupling portion, the mating member of claim 21, wherein (6).
  25. 連結手段(11)がねじ結合部を含むことを特徴とする、請求項21記載の相手部材(6)。 Characterized in that it comprises a coupling means (11) screwed portion, according to claim 21 of the mating member (6).
  26. プロテーゼ(1)が相手部材(6)内に受容可能な回転防止部を含むことを特徴とする、請求項22〜24のいずれか1項記載の相手部材(6)。 The prosthesis (1) is characterized in that it comprises a rotation preventing portion capable received within mating member (6), the mating member of any one of claims 22 to 24 (6).
  27. 中心軸線(4)と平行に見て延長部(3)の横断面が半円面であることを特徴とする、請求項20〜26のいずれか1項記載の相手部材(6)。 Wherein the central axis (4) and the extension portion when viewed in parallel cross section of (3) is semi-circular surface, the mating member of any one of claims 20 to 26 (6).
  28. 相手部材(6)を有する棘突起間プロテーゼにおいて、組立状態のときプロテーゼが中心軸線(4)に直角な対称平面を有することを特徴とする棘突起間プロテーゼ(1)。 In interspinous prosthesis having a mating member (6), interspinous prosthesis, characterized in that the prosthesis when in the assembled condition has a perpendicular plane of symmetry to the central axis (4) (1).
  29. 請求項20〜26のいずれか1項記載の相手部材(6)を有する請求項1〜19のいずれか1項記載の棘突起間プロテーゼ(1)。 Set forth in any one interspinous prosthesis according to claim 1 to 19 having a mating member of any one of claims (6) according to claim 20 to 26 (1).
  30. 棘突起間プロテーゼ(1)の延長部(3)が相手部材(6)の延長部に対して少なくとも2mm、好ましくは少なくとも3mmの距離を有することを特徴とする、請求項28または29記載の相手部材(6)を有する棘突起間プロテーゼ(1)。 At least 2 mm, preferably characterized in that it has a distance of at least 3 mm, partner of claim 28 or 29, wherein extension of the interspinous prosthesis (1) (3) to the extension portion of the mating member (6) interspinous prosthesis having a member (6) (1).
  31. 棘突起間プロテーゼ(1)の延長部(3)が相手部材(6)の延長部に対して最大15mm、好ましくは最大12mmの距離を有することを特徴とする、請求項28〜30のいずれか1項記載の相手部材(6)を有する棘突起間プロテーゼ(1)。 Extension of the interspinous prosthesis (1) (3) up to 15mm with respect to the extension of the mating member (6), preferably characterized in that it has a distance of up to 12 mm, it claims 28 to 30 interspinous prosthesis having a mating member according item 1 (6) (1).
  32. 棘突起間プロテーゼ(1)が第1回転防止部を含み、相手部材(6)が第1回転防止部に相補的な第2回転防止部を含み、棘突起間プロテーゼ(1)の延長部(3)と相手部材(6)の延長部(3)が互いに一直線に並ぶ位置に移動可能であることを特徴とする、請求項28〜31のいずれか1項記載の相手部材(6)を有する棘突起間プロテーゼ(1)。 The interspinous prosthesis (1) comprises a first rotation prevention portion, the mating member (6) comprises a second rotation preventing part complementary to the first rotation preventing part, the extension of the interspinous prosthesis (1) ( 3) the extension of the mating member (6) (3) is characterized in that it is moved to a position aligned with each other, having any one of claims mating member according to claim 28-31 (6) interspinous prosthesis (1).
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US20040199255A1 (en) 2004-10-07 application
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US7442208B2 (en) 2008-10-28 grant

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